Oxaliplatin

By Medically reviewed by hellodoktor

Generic Name: Oxaliplatin Brand Name(s): Oxaliplatin.

Uses

What is Oxaliplatin used for?

Oxaliplatin is used to treat advanced cancer of the colon and rectum. Oxaliplatin is a chemotherapy drug that contains platinum. It is used in combination with other medications to slow or stop cancer cell growth.

How should I take Oxaliplatin?

This medication is usually given by infusion into a vein over at least 2 hours by a health care professional. It is usually given every 2 weeks along with other medications (e.g., 5-fluorouracil and leucovorin). The dosage is based on your medical condition, body size, and response to therapy.

How do I store Oxaliplatin?

If you need to store oxaliplatin at home, talk with your doctor, nurse, or pharmacist about how to store it.

If you need to store oxaliplatin at home, talk with your doctor, nurse, or pharmacist about how to store it.

There may be different brands of Oxaliplatin that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Oxaliplatin down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Oxaliplatin?

Before using oxaliplatin, tell your doctor or pharmacist if you are allergic to it; or to other platinum-containing products (e.g., cisplatin, carboplatin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, blood disorders, bone marrow problems, nerve disorders.

Oxaliplatin may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using oxaliplatin, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).

Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/”water pills”) or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using oxaliplatin safely.

This drug may make you dizzy or cause vision changes. Alcohol or marijuana can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

Do not have immunizations/vaccinations without the consent of your doctor, and avoid contact with people who have recently received oral polio vaccine or flu vaccine inhaled through the nose. Wash your hands well to prevent the spread of infections.

To lower your risk of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.

Older adults may be more sensitive to the side effects of this drug, especially diarrhea, loss of too much body water and potassium, low white blood cell count, tiredness, fainting, and QT prolongation (see above).

This medication can affect sperm production in men. Therefore, men should use a reliable form of birth control during treatment and for some time afterwards. Consult your doctor for more details.

This medication is not recommended for use during pregnancy. It may harm an unborn baby. Discuss the use of reliable forms of birth control (such as condoms, birth control pills) with your doctor.

It is not known if oxaliplatin passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Oxaliplatin during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Oxaliplatin. Oxaliplatin is pregnancy risk category D according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Oxaliplatin?

Diarrhea, changes in taste, mouth sores, nosebleeds, tiredness, headache, dizziness, or trouble sleeping may occur. Nausea and vomiting may be severe in some patients. Your doctor may prescribe medication to prevent or relieve nausea and vomiting. Eating several small meals, not eating before treatment, or limiting activity may help lessen some of these effects. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Temporary hair loss may rarely occur. Normal hair growth should return after treatment has ended.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: pain/redness/swelling at the injection site, easy or unusual bruising/bleeding, mental/mood changes (e.g., depression), signs of too much body water loss (e.g., decreased urination, increased thirst, dry mouth), muscle pain/tenderness/weakness/cramps, signs of kidney problems (such as change in the amount of urine), pain/redness/swelling of the arms/legs, groin/calf pain.

Oxaliplatin can sometimes affect how your nerves work (peripheral neuropathy). Tell your doctor right away if you develop: sensitivity to cold, trouble breathing/swallowing/speaking, jaw tightness, strange feeling in your tongue, eye pain, chest pressure, numbness/tingling/”pins and needles” sensation of the hands/feet/mouth/throat.

You may lessen these types of nerve problems by avoiding cold drinks and ice and by dressing warmly. Tell your doctor right away if your nerve problems begin to interfere with your normal daily activities (e.g., walking, writing, eating).

Get medical help right away if you have any very serious side effects, including: severe dizziness, fainting, fast/irregular heartbeat, dry cough, shortness of breath, chest pain, black stools, vomit that looks like coffee grounds, vision changes (such as blurred vision, temporary vision loss), seizures, sudden confusion.

This medication can lower your body’s ability to fight an infection. Tell your doctor right away if you develop any signs of an infection such as fever, chills, or persistent sore throat.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Oxaliplatin?

Some products that may interact with this drug include: aminoglycosides (e.g., gentamicin, amikacin), amphotericin B, nalidixic acid, nonsteroidal anti-inflammatory drugs (e.g., ibuprofen), tacrolimus.

Oxaliplatin may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Oxaliplatin?

Oxaliplatin may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Oxaliplatin?

Oxaliplatin may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Oxaliplatin.

What is the dose of Oxaliplatin for an adult?

Usual Adult Dose for Colorectal Cancer

85 mg/m2 via IV infusion over 120 minutes every 2 weeks; administer in combination with infusional 5-fluorouracil and leucovorin.

Duration of Therapy:

-Adjuvant Treatment of Stage III Colon Cancer: Total of 6 months (12 cycles)

-Treatment of Advanced Colorectal Cancer: Until disease progression or unacceptable toxicity

Comments:

-Premedication with antiemetics, including 5-HT3 blockers with or without dexamethasone, is recommended.

-Consult the manufacturer product information for 5-fluorouracil and leucovorin dosing recommendations.

Uses: In combination with infusional 5-fluorouracil and leucovorin:

-Adjuvant treatment of Stage III colon cancer in patients who have undergone complete resection of the primary tumor.

-Treatment of advanced colorectal cancer.

Renal Dose Adjustments

-Mild to Moderate Renal Impairment (CrCl 30 to 80 mL/min): No adjustment recommended.

-Severe Renal Impairment (CrCl less than 30 mL/min): Reduce dose to 65 mg/m2.

Comments: Caution and close monitoring of all renally impaired patients are recommended.

Dose Adjustments

ACUTE TOXICITIES: Consider prolonging the infusion time for this drug from 2 hours to 6 hours.

AFTER RECOVERY FROM GRADE 3/4 GASTROINTESTINAL TOXICITY (DESPITE PROPHYLACTIC TREATMENT):

-Adjuvant Treatment of Stage III Colon Cancer: 75 mg/m2

-Treatment of Advanced Colorectal Cancer: 65 mg/m2

GRADE 4 NEUTROPENIA, FEBRILE NEUTROPENIA, OR GRADE 3/4 THROMBOCYTOPENIA: Reduce the dose and delay the next dose until neutrophils 1.5 x 10(9)/L or greater and platelets 75 x 10(9)/L or greater.

-Adjuvant Treatment of Stage III Colon Cancer: 75 mg/m2

-Treatment of Advanced Colorectal Cancer: 65 mg/m2

NEUROSENSORY EVENTS:

GRADE 2: Consider reducing the dose.

-Adjuvant Treatment of Stage III Colon Cancer: 75 mg/m2

-Treatment of Advanced Colorectal Cancer: 65 mg/m2

GRADE 3: Consider treatment discontinuation (for both indications).

Comments: Consult the manufacturer product information for dosing adjustment recommendations for 5-fluorouracil and leucovorin.

Other Comments

Administration Advice:

-Dilute this drug before administration; consult the manufacturer product information for dilution instructions.

-Consult the manufacturer product information for infusion instructions.

-Do not use needles or IV administration sets containing aluminum parts since aluminum has been reported to cause degradation of platinum compounds.

-Immediately discontinue drug administration and initiate usual local symptomatic treatment in the event of extravasation.

-Prior to administration, visually inspect for particulate matter and discoloration and discard if present.

-Prior to subsequent therapy cycles, evaluate patients for clinical toxicities and recommended laboratory tests.

-The administration of this drug does not require prehydration.

Storage Requirements:

-After dilution, the shelf life of this drug is 6 hours at room temperature (20 to 25 degrees Celsius/68 to 77 degrees Fahrenheit) or up to 24 hours under refrigeration (2 to 8 degrees Celsius/36 to 46 degrees Fahrenheit).

-Retain this drug in its original package until time of use. Do not freeze and protect from light; however, final diluted drug does not need protection from light.

Reconstitution/Preparation Techniques:

-Exercise care and use gloves when handling this drug. If a solution of this drug contacts the skin or mucous membranes, wash the skin immediately with soap and water and flush mucous membranes thoroughly with water.

IV Compatibility:

-Do not mix or administer this drug simultaneously through the same infusion line with alkaline medications or media (e.g., basic solutions of 5-fluorouracil, folinic acid preparations containing trometamol, trometamol salts of other active substances) as alkaline products will adversely affect the stability of this drug.

-Reconstitution/final dilution of this drug should not be performed with saline or other solutions containing chloride ions (including sodium, calcium, or potassium chloride).

-Consult the manufacturer product information for additional IV compatibilities and incompatibilities.

General:

-Overdosage: No known antidote.

Monitoring:

-Monitor a full blood count with white cell differential, hemoglobin, platelet count, and blood chemistries (including ALT, AST, bilirubin, and creatinine) prior to treatment initiation and before each subsequent treatment cycle.

-Monitor neurological toxicity; perform a neurological examination before each administration and periodically thereafter.

Patient Advice:

-Avoid potentially dangerous activities such as driving and operating machinery until you know how this drug affects you.

What is the dose of Oxaliplatin for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Oxaliplatin available?

Oxaliplatin is available in the following dosage forms and strengths:

  • Intravenous solution,
  • Intravenous powder for injection.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Oxaliplatin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: April 5, 2018 | Last Modified: September 12, 2019

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